title: A literature review of the outcomes after robot-assisted laparoscopic and conventional laparoscopic Nissen fundoplication for gastro-esophageal reflux disease in children.
abstract: BACKGROUND
  Robot-assisted surgery is a promising technical innovation. Given the similarities between laparoscopic and robot-assisted surgery it is unlikely that randomized controlled trials would be conducted to disclose any differences between these two technical instruments. Thus, skepticism remains due to lack of any definitive conclusions in the literature.
  
  
  OBJECTIVE
  The aim of the study was to disclose any difference in outcome after robot-assisted (RNF) versus conventional laparoscopic (LNF) Nissen fundoplication for gastro-esophageal reflux disease in children.
  
  
  METHODS
  A literature review was carried out. Only studies comparing the two modalities were included. Operative time, duration of hospital stay, 30 days morbidity, mortality, conversion, recurrence and complication rates were analyzed. Review Manager 5.1.6 software, from the Cochrane library, was used for statistical analysis.
  
  
  RESULTS
  Three case series fulfilled the criteria for inclusion in this review. Data on 174 children were identified; 89 were operated on using the computer-assisted technology and 85 controls were operated on using the conventional laparoscopic technique. Data showed no significant difference between these two modalities.
  
  
  CONCLUSIONS
  This literature review demonstrates no significant difference between patients operated on with robot-assisted surgery and those undergoing conventional laparoscopic surgery regarding the parameters studied.
  
  
  CONCLUSIONS
  The robot-assisted Nissen fundoplication in children is a safe alternative to conventional laparoscopic surgery. No data support the need for case selection to one of these two minimally invasive procedures.
authors.affiliation: Department of Pediatric Surgery, Skane University Hospital in Lund, and Lund University, 22185, Lund, Sweden.
authors.forename: Mette
authors.initials: M
authors.lastname: Hambraeus
authors.forename: Einar
authors.initials: E
authors.lastname: Arnbjörnsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Anderberg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication / Q000706:statistics & numerical data*; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012371:Robotics / Q000706:statistics & numerical data*; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome